Individual
TAMARA LYNN MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.A.A.
Contact information
Practice address
8954 HOSPITAL DRIVE, DOUGLASVILLE, GA 30134
(770) 920-6413
(678) 838-2532
Mailing address
5665 NEW NORTHSIDE DRIVE, ATLANTA, GA 30328
(770) 874-5400
(770) 874-6897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002716
GA
367H00000X
Anesthesiologist Assistant
Primary
002716
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199727917A
—
GA
05
—
491431789A
—
GA
Enumeration date
11/21/2005
Last updated
02/07/2014
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